Oral healthcare considerations in xerostomia treatment
Affecting upwards of 29% of patients, xerostomia, or the subjective feeling of dry mouth, is associated with a variety of etiologies. Oral health professionals are at the forefront of care for patients with xerostomia and all clinical staff members should be knowledgeable of common signs, symptoms and management.
While dental providers play a key role in identifying and treating xerostomia, nondental factors may also be related. Thus, an interprofessional approach involving the patient’s extended healthcare team can optimize care and address the potential behavioral and systemic components related to xerostomia.
Behavioral health factors, such as stress, depression and anxiety, play a significant role in xerostomia, specifically through the decrease of salivary flow rates and increase of subjective oral dryness.
In addition, substance use at any level is strongly associated with xerostomia, including drug, alcohol and tobacco use.
Older adults tend to experience xerostomia more frequently than the general population due to the higher likelihood of taking multiple medications.
Treatment of xerostomia includes evaluating the medications causing or exacerbating xerostomia, determining the risk-to-benefit ratio, and providing treatment recommendations to soothe symptoms. Interprofessional collaboration between dental professionals and medical providers and pharmacists is essential to manage this condition. Sometimes patients may be switched to an alternative medication that reduces dry mouth symptoms or reduces the additive impact of medications contributing to xerostomia. Even if alternative medications are not possible, adjunctive treatments may help ease symptoms. Mechanical stimulation methods, saliva substitutes/oral lubricants, and prescription medications (pilocarpine and cevimeline) are also available.
From Decisions in Dentistry. May 2023;9(5):34-36, 39.